Ron Hines DVM PhD

Elura® Cat Owner Feedback Page

Tell me about your cat’s experience with Elura®

Mirataz® appetite stimulant?

Back to parent Dog Entyce® article

Dog Owners Experiences With Entyce®

In October 2020, Elanco, the owners of Aratana, received FDA approval to market a second capromorelin product, Elura®, containing the same medication as in their Entyce® appetite stimulant for dogs.Their cat product was specifically designed to have a flavor more acceptable to cats and a lower strength formulation. The FDA granted approval to Aratana’s Elura® only to treat weight loss in cats that suffer from chronic kidney disease (CKD). In an attempt to minimize bureaucratic costs & paperwork and bring a medication to market in a timely manner, it is common for veterinary and human pharmaceutical companies to seek FDA approval for a single narrow use and just let veterinarians and physician prescribe medications “off label” as they see fit. Entyce® is sold in a 30 ml bottle with each ml containing 30 mg of capromorelin. Elura® is sold in a 15 ml bottle with each ml containing 20 mg of capromorelin in each ml. For now, this cat owner experience page will contain feedback from cat owners on both products. The suggested Elura® dose is 2 mg/kg (0.9 mg/lb) or 0.1 mL/kg (0.045 mL/lb) body weight once daily. But check your own Elura® product insert because those suggested dose and directions might change. Some of the older feedback on this webpage relates to cat owners using the dog product. That was before Elanco/Aratana received permission to market Elura®. If you want to add your observations on the results when your cat received Elura® let me know.

Owner updates in green,   My comments in purple 

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February 27, 2023

I have been using Elura since the beginning of December, so close to 4 months now with our 20 year old cat that has stage 4 kidney failure. After a number of attempts giving it as a liquid that our cat hated and vomited a number of times, I started using capsules based on some comments I found on the internet. That worked like magic. Initially, I was giving 0.3 ml (two capsules) every third day, alternating with mirataz and one day break. I found that with Elura alone, our cat seems hungry but still not wanting to eat, while using mirataz helped with some nausea, so this combination works the best. Recently we were giving Elura daily with a smaller dose, one capsule with only 0.2 ml but we are learning that this may have been too much as our cat gets very weak/dizzy from time to time about 30–40 minutes after getting Elura, so we may need to go back to every other or every third day. Overall, Elura was very helpful to get our cat to eat and regain some lost weight and the cat is still with us despite our vet preparing us for only days or weeks since she was diagnosed with stage 4. I hope my experience can help others trying to do the best they can for their cats with kidney failure.
Dorota

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Jan 3, 2023

Dear Mister Hines, 

I reach out to you with a question about Elura for cats. We live in The Netherlands and have a cat with chronic kidney disease. She has had a kidney infection lately that put her out of balance pretty heavy. The challenge is to get her to eat… We have tried everything. Most likely Elura will be the last thing we can try with her. She is only 11, and very healthy overall. We are under guidance of a doctor, and through her, we heard about Elura. Unfortunately, we cannot send it to The Netherlands via American websites. We are a bit desperate to get Elura to us as soon as possible as the appetite is pretty low… Do you think you might be able to help? Kind regards,

Stijn,  Maastricht, Netherlands

Jan 4, 2023 Dear Stijn, Is Entyce® available in the Netherlands? They are both capromorelin: Entyce: 30 mg/mL flavored solution in 10 mL, 15 mL and 30 mL bottles with measuring syringe Vanilla flavor, Elura®: 20 mg/mL. Before Elanco began to sell Elura, they suggested Entyce for cats: (read here) If neither are available, email Abbeyvet in the UK. Also contact Pointer Animal Hosp. in Marbella. Please let me know if you manage to obtain it, so I can let others know.  Ron 

January 4, 2023,  Unfortunately Abbeyvet cannot ship either. Looking for a way to have somebody private in the USA ship it to us now. We have a Dutch prescription, hope that works when we buy in the US. I will keep you posted, thank you for your help and thinking with us! Best, Stijn

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November 8, 2022

Is there some way to make Elura more palatable to cats? Mine resists and drools after I give her the med. 

R.G. Lancaster, PA

11-9-22 Dear R.G, I will put your question online to see if it gets answers. I taste everything I feed to my pets. If it doesn’t taste savory to me and if I can’t disguise it with a more pleasant meat broth, meat paste or hide it in a tidbit, capsule, or pill pocket, I don’t dispense it to cat owners. Vets are fortunate in that many meds come in injectable forms. But that’s not the case for Elura. Why don’t you ask Elanco (1-888-545-5973), the manufacturer of Elura, what they suggest and then let me know their reply? Many medications can be given rectally. I do not know if that is the case with capromorelin. The walls of the rectum absorb many medications quickly and effectively. But medications given that way avoid the “first pass effect” through a pet’s liver. That means that many drug doses given that way need to be reduced (less). So, I am certainly not telling you to attempt that either. The Company would have to weigh in on that. Best wishes, R.S.H.

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September 6, 2021

My 20-year-old cat was diagnosed with hypertension and chronic kidney disease after a sudden episode of retinal detachment.  His blood pressure prescription restored his eyesight, but mirtazapine did nothing for his poor appetite.  So my vet put him on Elura®. But after a week he’s still not eating on his own. I’m feeding him by syringe. He tolerates the food but is losing weight fast. He’s alert, not in pain, mobile with normal water intake and bowel movements. Any ideas what’s going wrong here?  Feedback on your sites says that cats have responded well and regain their appetites.  He doesn’t have much time left, otherwise.   

P.R @earthlink.net Sent from Mail for Windows

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March 5, 2021

Our 20-year-old tortoiseshell, Tori, was diagnosed with stage 3 kidney failure six months ago. We started Sub-Q fluids 100 mL and a kidney diet at that time. Tori was a good eater until the kidney diet foods started. As the months progressed she lost weight. We tried ALL the Vet Rx diets plus others. She would eat none of them very well. The appetite stimulant, mirtazapine, just caused a hyperactive state – but no eating. Cyproheptadine initially worked, but after a few weeks it stopped being effective.  Then Tori’s weight slipped to under 7 pounds – down a full 5 pounds in six months. Our Vet recommended Entyce®, but in reading the reviews they were both positive and negative.  So we proceeded with the lowest Entyce® dose possible. The recommended Entyce® dosage for cats is (0.9 mg/pound). Entyce contains 30 mg/ per 1 ml of solution.  So Tori needed a calculation of 0.9 x 7 pounds = 6.3 mg.   6.3 / 30 mg in 1 ml = 0.21 ml of Entyce® solution. We cut the recommend dosage in half to 0.10 ml of Entyce®.  Tori was eating within 20 minutes! And for the next 4 hours eating on and off. The next two days she was eating better with No Entyce®. Then the fourth day she stopped eating so we restarted Entyce® – again Tori was eating within 20 minutes. Then we administered Entyce® every other day for 2 weeks – Tori’s weight stabilized! Now Tori is getting 0.10 ml of Entyce® daily and eating well each day. We are hoping that Tori will soon be gaining weight!

 Thanks, 

JC, Las Vegas, NV

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December 20, 2020

My 4 year old, 9-pound cat became anorexic from one of the medications he was on. His neurologist prescribed Entyce at 0.2 ml once daily. I gave my cat its 1st dose before leaving the vet clinic. We arrived home about an hour later. My cat ate a bowl of his favorite food. He had zero side-effect from Entyce.  Another one of our cats was on Entyce too. Our 7 pound, 1 year old cat had a UTI and refused to eat. Her internal medicine specialist prescribed  0.2 ml of Entyce, she also ate within an hour and she had no side-effect from Entyce either. 

G.S.2016@gmail.com

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July 2, 2020

About 4 months ago my family vet gave me Entyce® for a cat who did not want to eat. It worked. About a month later I had another cat, who was referred to a neurologist. He was not eating well and I asked the neurologist if I could give him Entyce®. She works at a very large 24 hour animal hospital. She explained that they had some hospitalized cats who also developed the “lethargy” and they discovered that Entyce® was causing  a sudden, unexplained,  drop in blood pressure in some cats, which could be fatal, especially if it is administered at home where blood pressure cannot be checked. She told me to never give it to a cat. She wrote a prescription for an appetite stimulant that is safe for cats. I relayed the information to my family vet. She immediately stopped using it for cats.  

K.C., Sent from Mail for Windows 10

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June 2, 2020

My sweet 15 yo cat, Nessa, has stage 3 kidney issues and is not eating. My vet recommended Entyce®. After the first dose, she gobbled a bunch of food (not her prescribed kidney diet, but…) and promptly vomited it up. She sort of seems lethargic so I want to discuss options with my vet before giving her a second dose. Between that, subcutaneous fluids and other meds, I am sort of glad I am currently laid off.
N.N., Sent from my iPad

update: My vet suggested we try again with Entyce® and explained that cats can be tricky to deal with as far as appetite goes. After that, I will try to limit the amount of food she eats at one time. My vet has me rubbing a specially compounded benazepril on her inner ear flap as a vasodilator to enhance blood flow to her kidneys, Ringers lactate subcutaneously every day, Science Diet prescription kidney diet. Poor sweet thing shies away from me because she thinks I am going to give her medicine. My plan is to see if we can get her stable And eating more regularly over the next six weeks or so. Thank you for reaching out. Over the course of my 44 years of married life, she is one of our favorite rescues. She seems demure and sweet, deep down she is a feisty old broad!

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December 29, 2019

My vet has prescribed Entyce® for my elderly cat that has colon cancer.  He was very skinny and bony and has done very well on this medication.   He is eating well and has gained weight.   
C.D. ********@me.com>

Sent from my iPhone

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December 27, 2019

My 10-year-old cat has adenocarcinoma in her left sinus and her nose is constantly congested and she has trouble smelling. Her most recent blood work came back perfect but she had lost 1.5 lbs in just about 3 months. I noticed she was eating well and started her on mirtazapine- with this she became restless and extremely vocal and had no change in eating. My vet recommended Entyce®- 0.3cc. After 40 minutes of me giving her this medication she was so lethargic you’d have thought she was sedated. Her breathing became short and infrequent yet her tail was moving. I picked her up and she was completely limp in my arms. I pinched her paws and ears and she had no response. After reading your page and doing some Googling I realized lethargy was a side effect.  Just before she was walking around normally. It took almost 48 hours for her to return to her normal bubbly self.
J.S. **********@yahoo.com
Sent from my iPhone

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December 7, 2019

September 17, 2019

Hi, Sinatra [my cat] was diagnosed with stage 3 kidney failure and losing weight fast. The vet prescribed Entyce for stimulating her appetite, to try to stop the weight loss. After giving her 30 mg as prescribed, she immediately started drool and foamed at the mouth. Within a half hour she was lethargic and dazed, an hour later she couldn’t hold her head up, walk or sit without listing to the side. Lying down consisted of the “loaf” position with her head sideways, eyes open and dazed. I don’t know what this stuff did to her, but Its been 24 hours, and she is walking again but very shaky and only a few feet before she has to lay down to the loaf/head down sideways with eyes dazed. I would not recommend this to anyone for his or her cat and will be informing the vet who prescribed it to do more research before prescribing to someone else. 

M.W. Sent from my Verizon, Samsung Galaxy smartphone

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June 11, 2019

I  wanted to share my experience with Entyce for my cat, Emma.  She gradually stopped eating over the course of a few days.  Several vet/specialist visits later we found out she has a sarcoma on her mesenteric root. It is inoperable, radiation is impossible, and chemo is not effective. We are at a point of keeping her comfortable as long as possible. To help her eat, she was prescribed Cerenia® and 0.5ml Entyce a day. Her first couple of weeks of the Entyce were tough for her.  She definitely foamed at the mouth and continued to do so up until recently now that we are rounding her 3rd week on it.  If she takes it fast enough and I follow up with a treat there is very little foaming. She does not like the taste at all. It does stimulate her appetite. The Cerenia then helps the food stay down. I would like to take her off of the Entyce because it is such an ordeal to give it to her (she runs as soon as she sees the syringe) and I feel bad that it is so tough for her, but I am afraid she will stop eating again. She has become more like herself this past week than she has been since she first became ill. My husband did notice some off behavior when she first began taking the Entyce – she would go to her water or food bowl and after eating/drinking some she would lay her head right into the bowl. That was very odd but stopped after the first couple of doses. I have noticed some constipation but that could be the Cerenia®.  

Thank you,

A. T.

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May 9, 2019

My 9 lb. cat, Annie, was prescribed Entyce (.03 ml once daily) as an appetite stimulant. She had been recently discharged from an overnight stay at the emergency animal hospital for respiratory distress. She had not eaten anything for 2 days when I took her to my local vet for a recheck. The vet prescribed Entyce, but did not tell me it was off-label or the side effects [sometimes] associated with it. When I gave Annie her first dose, she started drooling [and] foaming at the mouth profusely. She seemed very disoriented and weak. I thought this was happening because it tasted terrible and that she was still reeling from being poked, probed and x-rayed so much in the past few days. It took her hours to somewhat recover from it.  I tried again the next day. Same results. She acted like she was given poison. [ ] I contacted Aratana, the drug manufacturer, to report Annie’s adverse reaction. They quickly responded and asked for more details and contact information for my vet. Shortly after, I received an email from my vet saying that if I return the bottle they will give me a full refund. This got me thinking and I researched this medication online. It is NOT FDA approved for cats, only DOGS.  It can be used for cats, but off label. I was not advised. I was shocked and angry that no mention was made of the possible side effects that Annie suffered. [ I suggest you] use this medication with extreme caution. There are other safer, proven appetite stimulants on the market for cats. 

Annie’s Mom

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April 23, 2019

Hi,

I came across your website when researching whether or not to give my cat Entyce (as prescribed by her vet as a last resort appetite stimulant). Our 4 year old cat was diagnosed with cancer that originated somewhere in her bile duct. She had a surgery to bypass/re-route the bile duct in order to also obtain a biopsy, and ultimately determined that the mass was cancerous and had spread to her lymph nodes. She had been on prednisolone and had a great appetite for 3-4 months until she suddenly vomited one night and never fully regained her appetite. We tried a variety of appetite stimulants and ultimately decided to try Entyce. She is a small cat (about 5 pounds) and reacted very negatively to Entyce – she seemed to get very drowsy and almost had seizure like reactions where she would be trying to fall asleep but suddenly start jerking and biting. While it passed after a few hours, it had minimal effect on her appetite. We stopped it after the seconds dose as it was not effective and had extremely bad side effects for her. Hope this can help another cat owner in the future.

J. Z.

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February 23, 2019

My cat has had little interest in food since a bout with a rhinovirus she picked up at the adoption center when I adopted her at age 4. Prior to that illness, she was cited as having normal appetite. Her appetite has been limited for all these years, and she has been consistently underweight. She also has hypertrophic cardiomyopathy which even further reduced appetite later in life. She has been taking mirtazapine, one-eighth tablet, every three days. While the side effects of restlessness and vocalization are reduced noticeably they are present even at this lower dose and it has kept her eating.

At her last check up, Entyce was recommended as having fewer side effects. Mindful of her strong reaction to the full dose (1/4 tablet) of Mirtazapine, I first tried a dose a bit more than half that recommended. She seemed unusually quiet all morning, and her appetite was not stimulated. She ate less than usual. I gave her the full dose this morning, and she is lethargic and uninterested in food 1.5 hours later. I had been told her appetite should pick up within 15 minutes of the dose.

I will go back to mirtazapine tomorrow. I don’t like it’s [Entyce’s] side effects, and really wish the Entyce would have helped her.

J.M., Sent from my iPad

March 24: I can add that I did try Entyce once more. I gave her nearly the fully prescribed dose. Just a couple minutes later, she vomited it all up.   I have not tried it with her since then.

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January 3, 2019

My 8 year old cat Patches has been given a tentative diagnosis of IBD or intestinal lymphoma. To keep his a vomiting under control he is being given a 1/2 tab of Cerenia® (16 ml) as needed for vomiting and 1/4 tab of Metronidazole (250 mg) per day for diarrhea. He has no appetite nor does he drink water at this point. I have been syringe feeding him since December 18th in hopes that this would kick-start him wanting to eat on his own.  I discussed this with my vet and she suggested giving him Entyce. I gave him .06 with the included dose syringe and his immediate reaction was to start salivating quite heavily.  He did not show any interest in eating and unfortunately, 20 minutes later, he vomited everything I had fed him 2 hours before along with the Entyce. Tomorrow I will once again attempt to give him some Entyce but at a somewhat smaller dose.  Hopefully I will get a better reaction and Entyce will get him back to eating again.      

Thank you for your time.       

Patches Mom,  Sent from my Galaxy Tab® A

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Dec 28, 2018 Updated Jan 4, 2019

Our 17 year old cat, Astra, is showing her age and we want her to be comfortable in her final time. Lately she has lost interest in food after being a chow hound all her life. We have been giving her Cypro [cyproheptadine] for 6 months or so on a routine basis but its effectiveness [for appetite] has waned so our vet prescribed Entyce. Her dose was 0.4 cc once a day. We just gave her the first dose and less than 10 minutes later she was at her food bowl, cleaned out a complete half meal and cried for more. She is a little hyped up too, so we will track her, but [we] will stop in a few days to see what she does without it.

The first time with good results but then her feeding fell off so we tried splitting it into two doses [of 0.2cc] but it was not as effective, then less effective with the usual full dose of 0.4 cc so we stopped it.

C.G. , East Bay of San Francisco

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December 12, 2018

I’m surprised nobody else has mentioned this. My cat started wildly foaming at the mouth as soon as I gave it [Entyce]. After that subsided, he looked and acted completely miserable – slinking around with [his] tail down, dilated pupils, wouldn’t purr. Finally he lay down for 20 minutes or so, completely motionless. [ ] Then all of a sudden he jumped up, went to his food [bowl] and gobbled voraciously for about a minute. This continued for a few rounds, at which point he moved to the water dish but just hunched over it, not drinking. For the next hour he was [] not himself and acted like he was in pain. Gradually and slowly he came around, but [it] gave me a huge scare.
Background info : [Entyce] was prescribed by [my] vet to stimulate a diabetes/insulin related loss of appetite. 

L. M. Washington State

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October 3, 2018

I started giving my 10-pound feline leukemia-positive cat, Smudge, 0.2 ml of Entyce today in an effort to get her to eat canned food for the extra water it provides. She is takes raltegravir, B-1 and B3 vitamins and Feline Interferon Omega to combat the feline leukemia virus. If one didn’t know she was FeLV+, one would think she is completely healthy. Smudge is a picky eater; I have tried every canned and dry food that is made. She favors eating dry Purina kitten chow, but even then, it sometimes takes cyproheptadine to get her to eat. Even a small dose of cyproheptadine makes her sleepy and not all there. I hate the way it makes her feel, but she will eat after taking it. Her being, FeLV+, I don’t have the luxury to let her not eat until she is starving. That’s why I wanted to try the Entyce. The first day I gave her Entyce, within fifteen minutes, she ate one and a half ounces of canned Fancy Feast. However, it was only effective the first day I gave it.

B.B. Jackson, Tennessee

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July 8, 2018

Summary: My 16 year old cat, Gilbert had a rise in his Creatinine and BUN–kidney issues. He was put on a low phosphorus, low protein, renal diet.  He was eating the new renal diet very well, but suddenly stopped eating, totally, for 3 days. mirtazapine used to work, but did not help, nor many special foods and treats.  Although Entyce, by Aratana, is only approved in dogs, my vet tried it at about 60 percent of the dose recommended for a dog of Gilbert’s weight. It worked great, with  soft stool as a side effect. Wrongly thinking more is better, we increased it to the full dosage for a 13 pound dog. His reaction, as only one individual cat, was deep depression, hiding, and one incident of involuntary head shakes.We dropped it back to 60 percent of the dog dose, the side effects, except soft stool immediately went away. He ate well at the lower 60 percent dose.  I  don’t know what the long term side effects are of Entyce, but it was urgent and lucky Entyce was available to get Gilbert eating. He gained weight. After two weeks, and we aren’t sure of when the need for it stopped, he is eating on his own, doing well, and I have a bottle on hand, in case. It is good 90 days from opening it.
If your cat needs it, I hope that it works as well for you. 

Neal, Nevada USA

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June 20, 2018

His Creatinine has dropped from 2.7 on June 8, down to 1.9, now. 1.9 is close to the 1.7 it was back in November before his decline. Every third day he still gets 2 mg of mirtazapine. He still drinks a lot of water and urinates a lot
His differential blood count numbers have gone from low to normal in two weeks.

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June 19, 2018

Per my conversation with Dr. M, we increased his Entyce from 0.3 ml up to 0.5 ml. He ate renal food when we got home. At 0.3 ml he wont eat renal food. He wants Fancy Feast at 0.3 ml. I need a blood type test to consult with U of Penn. They need type A. I am testing this and creatinine and BUN. [the owner is considering a kidney transplant for Gilbert]

June 18, 2018

Gilbert is taking 0.3 ml of Entyce every morning. It is working. I don’t see side effects. No depression, head movement, etc. He has gained 0.2 lbs since I last wrote. He is up to 13.3 lbs.  

June 15, 2018

Gilbert is a 16-year-old cat living in the Las Vegas Nevada area. He sees a feline veterinary specialist. He has as history of elevated blood creatinine, BUN and SDMA (kidney problems) but had eaten well and maintained his normal weight of 13.1 pounds. His blood phosphorus level has remained within normal limits. He is not at all enthusiastic about eating the special kidney diet his veterinarian prescribed for him. On June 1, Gilbert stopped eating. Mertazipine, an appetite stimulant, dispensed by the vet did not help. His weight dropped to 12 lbs. Even his favorite flavor of Fancy Feast did not interest him. Gilbert’s owner succeeded convincing another veterinarian to sell him Entyce:

My vet in Las Vegas does not use Entyce. None of the 10 hospitals I called would provide it either. They didn’t want to use it for a cat but I insisted and gave full permission. The Entyce works. He came home and ate a 3-ounce can of renal diet. He is having some kibble now an hour later. I don’t see any side effect. There is an immediate burst of hunger that rapidly tapers [off].

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February 13, 2018 update:

Bailey developed some head shaking and tipsiness that our vet thinks is related to an ear infection. So we discontinued Entyce for now. But I definitely feel that the medicine was a lifesaver for her. She was down to 4 lbs and would likely not be here without the medicine.

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February 2, 2018

We have a Main Coon cat, Bailey. We were given Entyce by our vet friend who had samples for dogs. She’s an older cat who was diagnosed with fatty liver [disease] and, as a result, had completely lost her appetite. She was hospitalized for over a week with IVs and then we finally decided to start giving her Entice when we brought her home to help her continue eating on her own.
The medication has definitely help increase her appetite. She has more desire to eat and is eating more on her own – although not quite as much as we would like. She has started displaying some weird behaviors with head shaking and loss of coordination while walking, but we are looking into maybe a possible ear infection or other explanation. We have reduced her dosage starting last night, in case it was causing the side effects, but I notice she hasn’t eaten as much today already.
We are hoping to be able to keep her on Entyce long enough so that she will not need it [anymore] and will be eating on her own, once her fatty liver condition has improved. I decided to email you since you said you would like information a pet owners using this on their animals, so let me know if you have any questions.

M. M., San Luis Obispo County, CA   Sent from my iPhone

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